Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

Abstract

There is insufficient evidence on SARS-CoV-2 induced neurological effects. Studies on CNS involvement during COVID-19 in children are limited. This study aims to identify and manage the neurological signs and symptoms in COVID-19-infected pediatric patients during follow up and plan future follow-ups.Children diagnosed COVID-19 and hospitalized in the pediatric pandemic services, between March 18, 2020, and June 18, 2021, were included in the study. Children with underlying neurological disease were excluded from the study. Patient data retrieved from hospital files and medical records. Children divided into 2 groups, 1 and 2, based on the presence or absence of neurological findings.A total of 243 children received follow-ups in the pandemic wards, 35 (14.4%) of these patients had neurological findings. Major neurological manifestations were headache (n:17, 7%), seizure (n:4, 1.6%), and anosmia/hyposmia (n:17, 7%). The number of boys (n:13, 37.1%) was smaller than the number of girls (n:22, 62.9%) in Group 1. Group 1 showed higher blood leukocyte, lymphocyte, thrombocyte, AST, LDH, d-dimer values. Anosmia/hyposmia occurred more often in girls, anosmia and headache occurred more often over 9 years of age. Pulmonary and hematologic involvement was more common in children with anosmia and headache.Our study is one of the few studies on neurological involvement in COVID-19 in children. To the best of our knowledge, there is limited data on these subjects in the literature. Abbrevations: AST = aspartate aminotransferase, CK = creatine kinase, CNS = central nervous system, COVID-19 = new type of coronavirus disease, CRP = C-reactive protein, CT = computed tomography, LDH = lactate dehydrogenase, NIMV = noninvasive mechanical ventilation, PICU = pediatric intensive care unit, PCR = polymerase chain reaction, SPSS = Statistical Package for the Social Sciences, WHO = world health organization.

Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study

“…Interestingly, the mentioned study showed, for the first time, the presence of SARS-CoV-2 in the brain tissue of a child with MIS-C and acute encephalopathy [ 34 ]. Additionally, patients with neurological manifestations had a significantly higher RBC count and hemoglobin level than patients without neurological manifestations ( p = 0.02 and p = 0.049, respectively), which is in agreement with the findings in another study on the neurological symptoms and signs associated with pediatric COVID-19 [ 35 ]. However, further studies are needed to confirm, explain, and correlate these findings with pediatric COVID-19-related neurological manifestations.…”

Subjective Smell Disturbances in Children with Sars-Cov-2 or Other Viral Infections do not Correspond with Olfactory Test Results

“…In our study, the frequency of test-based hyposmia in children with acute SARS-CoV-2 infection was 11.1 %, which is significantly lower than that in most other studies. A possible explanation is that in almost all studies, the frequency of hyposmia (varying from 1.9-86.1 %) was assessed only by questionnaires [1][2][3][4][5][6][7][8]. Only three stud- This document was downloaded for personal use only.…”

“…In children, olfactory disturbances are commonly reported in the context of SARS-CoV-2 infection, but the prevalence varies considerably from 1.9 % to 86.1 % [1][2][3][4][5][6][7][8]. This variance could be because the assessment of olfactory dysfunction was mostly based on questionnaires.…”

Cerebrospinal fluid viral etiology of patients with suspected central nervous system infections during the COVID-19 outbreak

“…According to studies, neurological symptoms appear in more than 35% of COVID-19 patients; in some patients, developing neurological manifestations are their rst symptoms. It is also well documented that SARS-CoV-2 has produced multiple changes in cerebrospinal uid (CSF) content, including increases in white blood cell counts and proteins [5]. A virus enters the CNS via the olfactory nerve, via retrograde transmission through other cranial or peripheral nerves (like the trigeminal nerve, which contains nociceptive cells in the nasal cavity or the vagus nerve), via lymphatic spread or through the choroid plexus, or by hematogenous spread [6].…”